Remedial Course & Clinical Documents

Click and download to enter your info or print the forms, complete the form by entering information requested in each form clearly, do this for all forms, sign all forms, mail all forms to our office (address at bottom of this page). Include copies of your ID/Driver license, SS Card, Insurance card, CPR card. Note: do not send documents by email, mail all documents to the school address. NOTE: All Documents must be submitted together one time. Do not send incomplete docs, to avoid loss of docs.  
Note that form #4.2 must be taken to a healthcare provider for completion and signature.

Required: immunization records – Physical, HEP B, MMR, Varicella titers, TB Screening.
Others: Background Check, Professional Liability insurance-on campus, Driver’s License, SS Card, proof of health insurance, AHA BLS CPR (Rophem AHA CPR)

A. Click here to order your Polo Shirt Clinical Female Polo  | Clinical Male Polo
Uniform must be ordered latest 2 weeks before start of clinical/live class, to make sure it will be ready. No one will be allowed to clinical without required uniform. 

B. Uniform For Live class Rophem Polo top on Navy Blue Scrubs pants, with clean shoes. Please do NOT use another color scrub pants.
C. Books are Students costs, the course payments does NOT include any book.

Number 1a. Read, sign, and mail to us – Remedial Course Instructions 

Number 1b. Read, sign, and mail to us – Student Enrollment Agree Form

Number 2. Read & sign the Clinical Instructions

Number 3. List of all documents you will need to submit – Course Requirements

Number 4. Complete your payment – half payment or full balance – PAY BALANCE HERE (due 2 weeks before class/course/clinical starts, late charge of $100.00 if not paid by the due date)

Number 5. Print & Sign PAYMENT PLAN POLICY
Payment Links:
LIVE + Clinical
Remedial Payment-1 (Live) $750.00 (due 2 weeks before class starts, late charge of $100.00 if not paid on time)
Remedial Payment-2 $700.00 (Live) (due 2 weeks before clinical starts, late charge of $100.00 if not paid by the due date)
ONLINE + Clinical
Remedial Payment-1 (Online theory) $680.00

Remedial Payment-2 $700.00 (Online) (due 2 weeks before clinical starts, late charge of $100.00 if not paid by the due date)

Number 6.  4-1. ROPHEM-PHYSICAL EXAM Form-Pg 1

Number 7. 4-2. ROPHEM-PHYSICAL EXAM Form-Pg 2 (must be completed by MD, PA, D.O., APRN)

Number 8. VECHS-Private-School-Waiver-Agreement-and-Statement-Form(1)

Number 9. Background Check ORI instructions

Number 10. Hepatitis B Vaccine Declination Form

Number 11. Acknowledgement of Risk and Release of Liability

Number 12. Drug testing – Do this within one month before clinical start date – DRUG TESTS  (Must be submitted with all documents – 2 weeks before clinical)

Number 13. Remedial Course Grade Calculations  

First: Go to Rophem CE Courses website and SIGN UP.
Create your username & password.
Then we will add the courses to your account after you paid for the Remedial Course.
Basic HIPAA Course & Elder Abuse, Neglect & Exploitation Course.
Print your certificate after completion of the course and submit copies with your documents. 

Any fees paid cannot be carried over to another year, course must be completed as scheduled. If you are unable to complete clinical within a specific year, you will be required to start over in the following year. Completed clinical training with Satisfactory result is only good for one calendar year.
Be sure to read and be familiar will all Remedial Theory and Clinical Policies.

Rophem Nursing Academy
3530 1st Ave North, Suite 201
St Petersburg, FL. 33713.

To your Success!


**Remedial Course Step by Step to completion – 12 weeks total.
Step 1 – After 100.00 deposit – Complete Forms & Payment (half or full)
Step 2 – Complete Required Clinical Documents
Step 3 – Create your online account. Start Theory – Live or Online
Step 4 – Submit all clinical documents & pay balance if applicable – due 2 weeks before clinical
Step 5 – Start Clinical Training based on group/dates selected.
Step 6 – Complete course, Pass all exams & Comprehensive Exams
Step 7 – Completion Letter sent to BON via email.

Answer to an important question:
At the completion of the course, if a student does not make the total grade of 70%, it means the student has not passed the course. In this case, the student will be given a choice to retake the Course exams and Comp/Cumulative exams to improve the final grades – for $500.00 (Discounted, theory portion only is $780). The length of this retake will be 3 months (90 Days).

Clinical training result is good for one calendar year.